What can chiropractors do at VA centers?

Now that a law calls for chiropractic services at Dept. of Veterans Affairs medical clinics, a committee will spend two years determining how that will work.

By Damon Adams, AMNews staff. Nov. 11, 2002.

Warren Jones, MD, said the law is clear about chiropractors working at Dept. of Veterans Affairs medical centers and clinics. They can provide services, but they are not to take over for primary care physicians.

The law enacted this year does not designate chiropractors as primary care practitioners but does call for new coverage of chiropractic services at VA centers and clinics, said Dr. Jones, chair of the board of directors of the American Academy of Family Physicians. What hasn't been determined is direct access, referrals and scope of practice of chiropractors.

Those matters are being hashed out by a chiropractic advisory committee appointed by the VA. Dr. Jones is one of the physician members of that committee.

Physicians and chiropractors are watching to see how chiropractic care will be integrated at VA centers.

Some chiropractors said the law means patients will have direct access to chiropractors.

"You now have a chiropractic profession that is fully ready to be a portal-of-entry doctor," said Michael McLean, DC, of Virginia Beach, Va., an advisory committee member. The law "simply means that if a person walks in off the street, we're capable of taking care of them or referring them to the appropriate health care practitioner."

But others question why there should be direct access to chiropractors and not to other practitioners.

"If you're going to offer direct access to chiropractors, why not offer direct access to psychiatrists," said Paul Shekelle, MD, PhD, a committee member and an internist at the West Los Angeles VA Medical Center. [...]